摘要
目的探讨宫颈液基细胞学检查(LBC)和高危型人乳头瘤病毒DNA检查(HR-HPV DNA)对宫颈高度鳞状上皮内病变子宫环形电切除术(LEEP)后切缘累及患者随访中的价值。方法选取2013年1月-2015年6月在湖南省妇幼保健院治疗的宫颈上皮高度鳞状上皮内病变,且切缘有病灶累及患者124例,随访术后12个月情况,并分别在术后3个月、6个月和12个月采用LBC和HR-HPV DNA进行检查。结果术后1年内有52.42%的患者LBC和HR-HPV DNA均阴性,47.58%的患者出现LBC异常和(或)HR-HPV DNA阳性;LBC异常和(或)HR-HPV DNA阳性者出现残留/复发比例为20.34%,明显高于LBC和HR-HPV DNA阴性者(6.15%),比较差异有统计学意义(χ2=5.537,P<0.05);LBC异常和(或)HR-HPV DNA阳性,提示病灶有残留或复发的灵敏度为75.00%,特异度为56.48%,阳性预测值为20.34%,阴性预测值为93.85%。结论宫颈高度鳞状上皮内病变且LEEP术后切缘累及患者,随访复查LBC和HR-HPV DNA检查,对评估病变残留/复发有一定作用。
Objective To investigate the value of liquid based cytology test（LBC） and high-risk human papillomavirus DNA examination（HR-HPV DNA） in patients with high grade cervical squamous intraepithelial lesions（HSIL） after loop electrosurgical excision procedure（LEEP） margin involved. Methods From January 2013 to June 2015,a total of 124 cases of HSIL patients with margin involved after LEEP were recruited. All of the cases were followed up for 12 months and were tested by LBC and HR-HV DNA at 3 months,6 months and 12 months after LEEP. Results After LEEP 12 months,the proportion of patients with negative results of LBC and HR-DNA tests was 52. 42%. And the proportion of positive results was 47. 58%. The residual/recurrence ratio among patients with positive results of LBC and（or） HR-HPV tests was 20. 34%. It was significantly higher than the patients with negative results of LBC and HR-HPV tests. The difference was statistically significant（χ2= 5. 537,P〈0. 05）. The sensitivity of positive results of LBC and（or） HR-HPV tests prompted residual or recurrence was 75%. The specificity was 56. 48%. The positive predictive value was 20. 34% and the negative predictive value was 93. 85%. Conclusion To follow up the results of LBC and HRHPV tests among HSIL patients with margin involved after LEEP can play a role on the assessment of residual/recurrence.
作者
陈颖
朱巧玲
唐毅
吴菲
贺彤
CHEN Ying;ZHU Qiao Ling;TANG Yi;WU Fei;HE Tong(Department of Obstetrics and Gynecology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha Hunan ,410008 , China)
出处
《中国妇幼卫生杂志》
2018年第1期55-58,共4页
Chinese Journal of Women and Children Health
